A survey of vascular access for haemodialysis in The Netherlands.
A survey of vascular access for haemodialysis in The Netherlands.
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荷兰血液透析血管通路的调查。
DOI：
10.1093/ndt/6.1.5
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
P. Leffers
中科院分区：
文献类型：
--
作者：
H. Burger;G. Kootstra;F. D. de Charro;P. Leffers
在进行了近30年的血液透析通路手术后，对大量人群中血管通路的调查似乎与分析最先进的技术水平有关。1988年1月1日，荷兰52个中心的2195名患者(人口14,714,900)因肾功能不全接受长期血液透析，588名患者接受持续非卧床腹膜透析(CAPD)。邮寄了一份调查问卷，回复率为100%。在所有长期接受血液透析的患者中，70%有Cimino瘘，22%有移植物瘘，6%有更近端的手臂瘘。其余2%的患者行Scribner分流术。其中以膨体聚四氟乙烯(EPTFE)移植物应用最多(58%)，其次为同种异体静脉移植物(25%)、自体静脉移植物(13%)和其他材料移植物(4%)。记录了急诊入路的偏好；17个中心几乎完全使用锁骨下静脉插管，而在24个中心中，超过50%的病例选择了锁骨下静脉插管。在6个中心中，股静脉几乎总是急性介入的首选，在17个中心中，超过50%的病例选择了股静脉。另一种选择，斯克里布纳分流术，在52个中心中的22个病例中进行了选择。经皮腔内血管成形术(PTA)作为一种治疗血管通路狭窄的方法，常规应用于5个中心，偶尔应用于19个中心。
After nearly 30 years of access surgery for haemodialysis, a survey of vascular access in a large population seemed relevant in order to analyse the state of the art. On 1 January 1988, 2195 patients in 52 centres in The Netherlands (population 14,714,900) were on long-term haemodialysis and 588 on continuous ambulant peritoneal dialysis (CAPD) for renal insufficiency. A questionnaire was mailed out, to which there was 100% response. Of all the patients on long-term haemodialysis, 70% had a Cimino fistula, 22% a graft fistula, and 6% a more proximal arm fistula. The remaining 2% had a Scribner shunt. Of all the graft fistulae, the expanded polytetrafluoroethylene (ePTFE) graft was the one most used (58%), followed by the homologous vein graft (25%), the autologous vein graft (13%), and those made of other materials (4%). Preference for acute access was recorded; catheterisation of the subclavian vein was used almost exclusively in 17 centres, while in 24 centres it was chosen in more than 50% of the cases. The femoral vein was almost always the choice for acute access in 6 centres and it was selected in more than 50% of the cases in 17 centres. Another alternative, the Scribner shunt, was applied in selected cases in 22 of the 52 centres. Percutaneous transluminal angioplasty (PTA), as a method for treating stenoses in vessels used for vascular access, was applied routinely in 5 centres and occasionally in 19 centres.